When the time comes to find an attorney it is important that the attorney be knowledgeable of all the issues that may affect you, including the possible need for Medicaid benefits.

Medicaid is a joint state and federal program. In very simple terms, the federal government lays out a framework and allows the different states to design their own programs that fit within the framework. As a result, different states can have vastly different policies when it comes to Medicaid eligibility, spend-downs, division of assets, and exempt vs non-exempt assets.

Kansas VS Missouri

Of course, there are some standards that are set at the federal level but even the amount of money you can protect varies from state to state. For example, currently for a single person to qualify for nursing home Medicaid in Missouri the countable assets need to be under $5,726.00. In Kansas, the assets have to be under $2,000.00.

There are also differences in how states treat the assets. For example, if a wife or husband is in a nursing home in Kansas the retirement accounts owned by the spouse who is still at home are exempt. In Missouri, those same retirement accounts are considered an available asset that must be reduced below the Medicaid limit.

Living Trusts

One issue that comes up for our office working in both Kansas and Missouri has to do with trusts. They can be an effective tool to avoid probate so it is quite common for someone who has a trust to place their house in their trust. As a general rule, the house is an exempt asset and this is not a problem if they are applying for Medicaid in Missouri. However, Kansas says that if the house is titled to a trust then it is a countable asset. The equity value of the house is treated the same as money in the bank.

Gifts and Transfers

One final difference to note, although there are many others, is the way states treat gifts and transfers. When applying for Medicaid you are required to report any assets that have been sold, transferred, or given away. Giving away assets causes Medicaid penalties and during the penalty, the person is ineligible for benefits. The state takes the total amount of the gifts and divides it by a number to determine the length of the penalty. In theory that number is based on the average cost for a nursing home in the state. In Kansas every $247.62 gifted is one day of penalty. In Missouri every $7,536.00 gifted is one month of penalty.

As you can see, there can be some very important differences in how you should approach your short and long-term planning depending on your location. And while the internet is a helpful tool, much of the Medicaid information you receive is not state-specific to your needs. What works for someone in Missouri may not work for someone in Kansas. This is why you should always be certain to consult with an elder law attorney before applying for Medicaid who is well versed in how your specific state policies work.